The aim of this research was to analyse and compare clinical governance and quality management initiatives at hospitals in England and Germany in terms of content, implementation and effects as perceived by managerial, clinical and non-clinical staff working in elderly-related, acute stroke care in order to identify ‘valued’ practice approaches and develop recommendations for overall improvement. The research applied a comparative case-study design to address this aim. Documentary analysis prepared the site visits. Interviews with 83 representatives of different staff groups were conducted at a pilot-case and eight elderly-related, acute stroke care units, four of which were located in England and four in Germany. The findings from the cross-case analysis were compared to the views of 17 experts from England, Germany and Florida. The research contributes to knowledge by widening the scope of previous research in two senses. First, the researcher applied a qualitative research design and interviewed a wider spread of different professions, including managers, consultants, nurses, therapists and support staff, than has been done in previous research. Secondly, the interview questions focused not only on the quality understanding or quality implementation issues, but also extended the areas of discussion to include ‘valued’ practice and suggested improvements. The findings of the case-study analysis highlight six emerging themes, which confirm general issues from the quality management literature, such as an unclear impact on efficiency or the ‘them versus us’ phenomenon, for the hospitals. Moreover, these themes and the general findings from the research confirm and develop in greater detail the hospital specific issues of quality management and clinical governance. Examples include the contentious role of consultants, the need for more partnerships in healthcare and scarcity of resources. Most importantly, staff confirmed that clinical governance and quality management resulted in safer, more consistent care to better meet patient needs. Based on these findings, recommendations were developed for four areas, i.e. organisation-wide concerns, staff-specific issues, political and systems aspects, as well as further research.
| Identifer | oai:union.ndltd.org:bl.uk/oai:ethos.bl.uk:526951 |
| Date | January 2011 |
| Creators | Halank, Alina |
| Contributors | Reed, Deborah Margaret ; Hoecht, Andreas Herbert ; Wood, Michael John |
| Publisher | University of Portsmouth |
| Source Sets | Ethos UK |
| Detected Language | English |
| Type | Electronic Thesis or Dissertation |
| Source | https://researchportal.port.ac.uk/portal/en/theses/quality-management-at-european-hospitals(def4105d-1e1b-4c77-b9e6-c52013078aa9).html |
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